The Effect of Adult and Pediatric Cardiopulmonary Bypass on Pharmacokinetic and Pharmacodynamic Parameters

Cardiopulmonary bypass (CPB) is known to have important effects on the
disposition of drugs, which in turn may have important implications for
the efficacy and toxicity of drug therapy. These effects constantly
change throughout CPB and some continue to exert influence after the
patient has been successfully weaned. In children, developmental and
disease specific changes in drug disposition and effect also need to be
taken into account when studying the effects of CPB. This review will
provide an extensive overview of the current literature concerning the
mechanisms behind the effects CPB has on pharmacokinetic and
pharmacodynamic parameters. Also the effects of CPB on individual
anesthetic drugs and sedatives, opioids, neuromuscular blocking agents,
antibiotics and miscellaneous medications will be reviewed. Special
attention will be paid to the pediatric population.